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Pathology/Lab Coding Alert

READER QUESTIONS:

Capture Separate LDL Opportunity

Published on Thu Apr 23, 2009

Question: Can we report a direct LDL test in addition to the calculated LDL that is part of the lipid panel? Iowa Subscriber Answer: If the physician orders a separate LDL test in addition to the lipid panel based on clinical conditions that indicate medical necessity, you can report both codes: - 80061 " Lipid panel - 83721 " Lipoprotein, direct measurement; LDL cholesterol. Example: A patient has a familial dyslipidemia resulting in severe hypertriglyceridemia (272.1). The high triglyceride level may adversely affect the assay and invalidate a calculated LDL value. The physician orders a separate direct LDL measurement because the patient's results may impact her treatment, such as changes to her dietary or pharmacological therapies. Bill both the lipid panel and the LDL test, but append modifier 59 (Distinct procedural service) to 83721 to override the Correct Coding Initiative (CCI) edit pair that prohibits billing the two codes together. [...]
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